title: Treatment-related mortality in patients with advanced-stage hodgkin lymphoma: an analysis of the german hodgkin study group.
abstract: OBJECTIVE
  The introduction of BEACOPP(escalated) (escalated-dose bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) has significantly improved tumor control and overall survival in patients with advanced-stage Hodgkin lymphoma. However, this regimen has also been associated with higher treatment-related mortality (TRM). Thus, we analyzed clinical course and risk factors associated with TRM during treatment with BEACOPP(escalated).
  
  
  METHODS
  In this retrospective analysis, we investigated incidence, clinical features, and risk factors for BEACOPP(escalated)-associated TRM in the German Hodgkin Study Group trials HD9, HD12, and HD15.
  
  
  RESULTS
  Among a total of 3,402 patients, TRM of 1.9% (64 of 3,402) was mainly related to neutropenic infections (n = 56; 87.5%). Twenty of 64 events occurred during the first course of BEACOPP(escalated) (31.3%). Higher risk of TRM was seen in patients age ≥ 40 years with poor performance status (PS) and in patients age ≥ 50 years. PS and age were then used to construct a new risk score; those with a score ≥ 2 had TRM of 7.1%, whereas patients who scored 0 or 1 had TRM of 0.9%.
  
  
  CONCLUSIONS
  The individual risk of TRM associated with BEACOPP(escalated) can be predicted by a simple algorithm based on age and PS. High-risk patients should receive special clinical attention.
authors.affiliation: University Hospital of Cologne, Cologne, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Wongso
authors.forename: Michael
authors.initials: M
authors.lastname: Fuchs
authors.forename: Annette
authors.initials: A
authors.lastname: Plütschow
authors.forename: Beate
authors.initials: B
authors.lastname: Klimm
authors.forename: Stephanie
authors.initials: S
authors.lastname: Sasse
authors.forename: Bernd
authors.initials: B
authors.lastname: Hertenstein
authors.forename: Georg
authors.initials: G
authors.lastname: Maschmeyer
authors.forename: Tom
authors.initials: T
authors.lastname: Vieler
authors.forename: Ulrich
authors.initials: U
authors.lastname: Dührsen
authors.forename: Walter
authors.initials: W
authors.lastname: Lindemann
authors.forename: Walter
authors.initials: W
authors.lastname: Aulitzky
authors.forename: Volker
authors.initials: V
authors.lastname: Diehl
authors.forename: Peter
authors.initials: P
authors.lastname: Borchmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Engert
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001761:Bleomycin / Q000009:adverse effects; D015992:Body Mass Index; D003520:Cyclophosphamide / Q000009:adverse effects; D003606:Dacarbazine / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D005047:Etoposide / Q000009:adverse effects; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000009:adverse effects; D011344:Procarbazine / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D014747:Vinblastine / Q000009:adverse effects; D014750:Vincristine / Q000009:adverse effects
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D003606:Dacarbazine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone